Well, I finally got sick again. It was inevitable. But this has given me the opportunity to revisit the experience of doctor appointments and health in La Paz.
Apparently, I have salmonella. That was news to me! I think if I had gotten salmonella in the US, I would have been scared. I don’t know anyone who has gotten salmonella and the only times I heard of it, it was this scary, serious health concern. Not to say that it isn’t serious, but I feel better knowing that, according to my host sister, it’s quite common here.
Last year I got very sick with typhoid fever, which I believe comes from a strain of salmonella or other. So in a way, this is familiar territory. I visited a clinic in Achumani with only Spanish-speaking staff and doctors. I had my weight and height taken, and a physical exam from a doctor. Yesterday my blood was drawn to definitely know what was causing me to feel so awful. When my host sister and I returned to the clinic to get the test results, my doctor was serious about explaining the gravity of my health issues (which is not limited to salmonella). At the same time, he was very humorous and laughed at the heinous diet I would need to undertake to improve my health, which included eating liver and drinking a tonic that tastes like rotten prunes (tried and tested).
Having to use Spanish to communicate about my health was beneficial for me, and surprisingly easy! Of course, there were some terms I didn’t understand and needed my host sister and decode for me, but I was able to understand the conversation. I think this is due in large part because the doctor was such a character and made it easy to understand him. That brought me to think about bedside manner and humor in healthcare. Each doctor is different and how they care for their patients but in my experience in Alaska (with Lower 48-trained doctors), doctors tend to be quick, to the point, and leave little room for jokes.
I go to a walk-in clinic in Fairbanks, and the doctors I see are often serious and seem anxious to get to the next patient. That hasn’t been my experience in La Paz at the Achumani clinic. The doctor I saw was serious in one moment, explaining my blood test results, and in the next minute outright laughing and enjoying himself. I never felt like we were being rushed out of the office, it was casual and even seemed chatty. Measuring bedside manner seems like a difficult or impossible task since each doctor and healthcare provider brings their own style and personality to work, but in my limited experience, I’ve noticed a whole different environment. Programs on waiting room TVs include Bigote! and the telenovela La Rosada de Guadalupe, complete with overdramatic crying and waiting room patients carrying on conversations over the TV noise. The waiting room has been an unlikely place for me to talk with my host sister about the different aspects of life in La Paz and Fairbanks, Alaska.
And as a last note, the doctors in Bolivia really do pile on the medicines! I noticed this last year as well, I was given stacks of different medicines to use. It’s a bit confusing, but I think I have two for anemia, two for salmonella, and then a medicine for my medicines (to make sure all the medicine I’m taking doesn’t damage my organs). Comparatively, in the US and Alaska, I would probably walk out of the clinic with a prescription for one or two medicines. When my host sister and I left the Achumani clinic yesterday, we had two small plastic grocery bags full of medicine.